Medicare Savings Programs Income Limits by State: 2026 Guide

Your parent is $50 over the QMB income limit — at least under the federal numbers. But those federal numbers are a floor, not a ceiling, and several states have raised the bar substantially. Whether your parent qualifies may come down to which side of a state line they live on.

The Federal Baseline (2026)

The standard monthly income limits, which include the $20 unearned income disregard, are:

These numbers derive from the federal poverty level published annually by HHS, plus the standard $20 monthly disregard applied to unearned income under the SSI methodology. Your parent's actual gross income can be $20 higher than these figures because the disregard is subtracted during the eligibility calculation.

Alaska and Hawaii use higher poverty guidelines, which raises all MSP income limits in those states. For example, Alaska's QMB limit is $1,683/month individual and $2,275/month couple.

States With Higher Income Limits

Several states have expanded eligibility well beyond the federal baseline using state-specific rules and, in some cases, less-restrictive income methodologies under Section 1902(r)(2) of the Social Security Act:

District of Columbia — $4,010 individual / $5,430 couple (QMB) DC has effectively converted QMB into a single, comprehensive eligibility tier by raising the income limit to approximately 300% FPL. A parent earning $4,000/month in Social Security and pension income qualifies for full QMB coverage — premiums, deductibles, coinsurance, and copayments all covered.

Connecticut — $2,752 individual / $3,719 couple (QMB) Connecticut's expanded QMB threshold covers seniors with moderate incomes who would be ineligible in most other states. Combined with Connecticut's abolished asset test, this makes the state one of the most generous for MSP enrollment.

Indiana — $2,015 individual / $2,725 couple (QMB) Indiana's limits are roughly 150% FPL, providing a significant expansion over the federal 100% FPL baseline.

Mississippi — $1,380 individual / $1,854 couple (QMB) Mississippi uses a $50 monthly unearned income disregard instead of the standard $20, raising the effective income ceiling slightly above the federal baseline.

How Income Is Calculated

The MSP income calculation follows the SSI methodology, which differs from the modified adjusted gross income (MAGI) rules used for Marketplace insurance:

Counted:

• Social Security benefits (gross amount before Medicare premium deduction)
• Pensions and annuities
• Employment wages
• Interest and dividend income
• Rental income
• Veterans benefits (some types)

Not counted:

• The first $20/month of unearned income (standard disregard)
• The first $65/month of earned income, plus half of remaining earnings
• Food assistance (SNAP benefits)
• Home energy assistance (LIHEAP)

The critical number is the gross Social Security benefit — the amount before the Part B premium is deducted. Many caregivers mistakenly use the net deposit amount, which understates income by $202.90/month. The caseworker uses the gross figure.

Under 20 CFR § 416.1233, retroactive Social Security payments are excluded from countable resources for nine months after receipt when kept separate and identifiable.

The Social Security Fairness Act Complication

If your parent received increased Social Security benefits after the WEP/GPO repeal, their monthly income may have jumped by an average of $360. That increase alone can push a parent from eligible to ineligible under the federal QMB limit.

Run the numbers with the new, higher benefit amount. If your parent now falls between the QMB and SLMB limits, they still qualify for SLMB (Part B premium coverage). If they're between SLMB and QI limits, QI still covers the premium. And if they're above QI limits, check whether Extra Help eligibility remains — its income threshold runs higher at $1,995/month individual.

Also check whether your state uses expanded limits. A parent who's $100 over the federal QMB threshold might still qualify in Connecticut, Indiana, DC, or Mississippi.

Find Your State's Exact Numbers

State income limits change annually when the federal poverty level updates in late January. Your state Medicaid agency publishes current limits, or call a SHIP counselor who tracks the numbers for your specific state.

The Medicare Savings Programs toolkit includes the eligibility screening worksheet with the full income calculation methodology, disregard rules, and step-by-step guidance for determining which MSP tier your parent qualifies for.

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